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Cancer-Related Changes in Sexuality and Reproduction . Objectives. The learner will be able to : Differentiate between sexual and reproductive alterations. Describe the effect of sexual and reproductive alterations on quality of life. . Altered Sexuality.
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Objectives The learner will be able to: • Differentiate between sexual and reproductive alterations. • Describe the effect of sexual and reproductive alterations on quality of life.
Altered Sexuality • Changes in sexual desire/pleasure/interest • Changes in libido • Altered body image and self-esteem • Troubling symptoms: Fatigue, nausea, depression, anxiety
Altered sexual function • Sexual functioning • Erectile dysfunction • Dyspareunia • Functional/structural changes to sexual organs
Reproductive Issues • Temporary or permanent infertility • Surgery • Radiation therapy • Medications (chemotherapy and hormones) • Teratogenicity of chemotherapy
Assessment of Sexuality • Overcoming barriers • Routine component of informed consent, assessment, and teaching • Right time and setting to explore sensitive topics • Sexuality assessment tools • Testosterone levels
Management of Altered Sexuality • Decreased libido • Few evidence-based recommendations • Lower body image and self-esteem • Discuss changes; explore meaning. • Interventions to restore/replace body function and appearance
Management of Altered Sexuality • Erectile dysfunction • Medications, prostheses, rehabilitation • Dyspareunia • Moisturizers and lubricants • Changes in sexual organ function/structure • Alternate positions, activities
Infertility • Male • Sperm banking • Female • Embryo preservation • Oocyte or ovarian tissue cryopreservation • Ovarian function suppression with gonadotropin-releasing hormone agonist
References Demeestere, I., Moffa, F., Peccatori, F., Poirot, C., & Shalom-Paz. (2011). Multiple approaches for individualized fertility protective therapy in cancer patients. Obstetrics and Gynecology International, 2012, 1-12. doi: 10.1155/2012/961232 Kaplan, M., & Pacelli, R. (2011). The sexuality discussion: Tools for the oncology nurse. Clinical Journal of Oncology Nursing, 15(1), 15-17. doi: 10.1188/11.CJON.15-17 Leonard, M., Hammelef, K., & Smith, G.D. (2004). Fertility considerations, counseling, and semen cryopreservation for males prior to the initiation of cancer therapy. Clinical Journal of Oncology Nursing, 8(2), 127-131. doi: 10.1188/04.CJON.127-131. Nishimoto, P.W., & Mark, D.D. (2010). Altered sexuality patterns. In C.G. Brown (Ed.), A guide to oncology symptom management (pp. 423-456). Pittsburgh, PA: Oncology Nursing Society. Shear, A. (2010). Fertility preservation: An option for women with cancer? Clinical Journal of Oncology Nursing, 14(2), 240-242.doi: 10.1188/10/CJON.240-242 Southard, N.Z., & Keller, J. (2009). The importance of assessing sexuality: A patient perspective. Clinical Journal of Oncology Nursing, 13(2),213-217. doi: 10.1188/09. CJON.213-217